Reconsideration of the Indications for Adjuvant Chemotherapy for Liver Metastases from Colorectal Cancer After Initial Hepatectomy

Background The effectiveness of perioperative adjuvant chemotherapy for colorectal cancer liver metastasis (CRLM) remains a matter of debate. Despite the lack of clear evidence supporting its effectiveness after curative hepatectomy, adjuvant chemotherapy has been widely used clinically. The purpose...

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Bibliographic Details
Published in:Annals of surgical oncology 2014-01, Vol.21 (1), p.139-146
Main Authors: Hirokawa, Fumitoshi, Hayashi, Michihiro, Miyamoto, Yoshiharu, Asakuma, Mitsuhiro, Shimizu, Tetsunosuke, Komeda, Koji, Inoue, Yoshihiro, Uchiyama, Kazuhisa
Format: Article
Language:English
Subjects:
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Chemotherapy, Adjuvant
Colorectal Neoplasms - mortality
Colorectal Neoplasms - pathology
Colorectal Neoplasms - therapy
Combined Modality Therapy
Female
Follow-Up Studies
Hepatectomy
Hepatobiliary Tumors
Humans
Liver Neoplasms - mortality
Liver Neoplasms - secondary
Liver Neoplasms - therapy
Male
Medicine
Medicine & Public Health
Neoplasm Staging
Oncology
Prognosis
Surgery
Surgical Oncology
Survival Rate
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Summary:Background The effectiveness of perioperative adjuvant chemotherapy for colorectal cancer liver metastasis (CRLM) remains a matter of debate. Despite the lack of clear evidence supporting its effectiveness after curative hepatectomy, adjuvant chemotherapy has been widely used clinically. The purpose of this study was to clarify the indications for adjuvant chemotherapy in order to develop an appropriate treatment strategy for CRLM. Methods The clinicopathological factors of 110 patients who underwent initial hepatectomy for CRLM between April 2000 and March 2010 were retrospectively analyzed. The prognostic factors of CRLM were identified and then CRLM was stratified according to the number of prognostic factors into the high-score group (H-group: score 2 or 3) and the low-score group (L-group: score 0 or 1), and the effectiveness of adjuvant chemotherapy was analyzed in each group. Results Multivariate analysis identified pT4 ( p  = 0.0047), lymph node metastasis in colorectal cancer (CRC) ( p  = 0.0165), and H2-classification ( p  = 0.0051) as factors related to a poor prognosis. The overall 5-year survival rate was markedly higher in the L-group (68 %) than in the H-group (26 %, p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-013-3310-1